The procedure for harvesting bone marrow has changed very little since 1970. Marrow is collected from the posterior iliac crest using large-bore needles to aspirate the marrow into syringes that have been rinsed with a heparin-containing solution. The cortical bone is penetrated, and 4-10 mL of marrow is aspirated and transferred to a container with anticoagulant solution. The aspiration needle is advanced several millimeters, and the process is repeated. Several aspirations can be made through a single bone puncture, and the bone may be punctured multiple times from a single skin entry site.
A typical collection involves 200-300 marrow aspirations through two skin incisions (2). The volume collected is determined by the nucleated cell count in the collected marrow and by the recipient's weight. The target is usually two to four x 108 nucleated cells per kilogram of the recipient's weight (2). On average, one liter of marrow is collected. NMDP regulations prohibit collections larger than 1.5 liters.
After the collection is completed, the donor's hemoglobin and hematocrit are measured, and if necessary, the donor is given an autologous transfusion of packed red blood cells from units of blood usually collected from the donor approximately a week before the harvest.
